Interventions to reduce medication errors in adult intensive care: a systematic review

Manias, Elizabeth, Williams, Allison and Liew, Danny 2012, Interventions to reduce medication errors in adult intensive care: a systematic review, British journal of clinical pharmacology, vol. 74, no. 3, pp. 411-423, doi: 10.1111/j.1365-2125.2012.04220.x.

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Title Interventions to reduce medication errors in adult intensive care: a systematic review
Author(s) Manias, ElizabethORCID iD for Manias, Elizabeth
Williams, Allison
Liew, Danny
Journal name British journal of clinical pharmacology
Volume number 74
Issue number 3
Start page 411
End page 423
Total pages 13
Publisher Wiley-Blackwell Publishing
Place of publication London, Eng.
Publication date 2012-09
ISSN 1365-2125
Keyword(s) intensive care
medication errors
systematic review
Critical Care
Critical Illness
Intensive Care Units
Practice Guidelines as Topic
Professional Role
Research Design
Summary Critically ill patients need life saving treatments and are often exposed to medications requiring careful titration. The aim of this paper was to review systematically the research literature on the efficacy of interventions in reducing medication errors in intensive care. A search was conducted of PubMed, CINAHL EMBASE, Journals@Ovid, International Pharmaceutical Abstract Series via Ovid, ScienceDirect, Scopus, Web of Science, PsycInfo and The Cochrane Collaboration from inception to October 2011. Research studies involving delivery of an intervention in intensive care for adult patients with the aim of reducing medication errors were examined. Eight types of interventions were identified: computerized physician order entry (CPOE), changes in work schedules (CWS), intravenous systems (IS), modes of education (ME), medication reconciliation (MR), pharmacist involvement (PI), protocols and guidelines (PG) and support systems for clinical decision making (SSCD). Sixteen out of the 24 studies showed reduced medication error rates. Four intervention types demonstrated reduced medication errors post-intervention: CWS, ME, MR and PG. It is not possible to promote any interventions as positive models for reducing medication errors. Insufficient research was undertaken with any particular type of intervention, and there were concerns regarding the level of evidence and quality of research. Most studies involved single arm, before and after designs without a comparative control group. Future researchers should address gaps identified in single faceted interventions and gather data on multi-faceted interventions using high quality research designs. The findings demonstrate implications for policy makers and clinicians in adopting resource intensive processes and technologies, which offer little evidence to support their efficacy.
Language eng
DOI 10.1111/j.1365-2125.2012.04220.x
Field of Research 111099 Nursing not elsewhere classified
1115 Pharmacology And Pharmaceutical Sciences
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, The Authors
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